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pedicle tram flap/abdominal buldge complication
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pedicle tram flap/abdominal buldge complication

Wondering how many woman suffering severe abdominal bulge/weakened stomach wall and severe digestive issue's years post pedicle tram flap? I am finally finding some admittance of this severe and debilitating side effect. Not many Dr's seem to want to associate it with the pedicle tram flap or acknowledge this very serious complication. Granted, in 2004 this was a relatively new surgery, we could not know all side effects. However, I seem to see this happening not just to me but to others and no one wants to discuss or find a fix. My left side of my abdoman has completely buldged out. This happend in 2011. My surgery was 2004. You can actually see the outline of my intestines. I went to ER thinking I had a severe hernia, possibly a blockage. The "Buldge" had increased greatly in size. Along with this came constipation and pain. It seems I am experiencing on going blockages in my intestines and colon. Without the strength of the rectus muscle my stomach has become so weak it cannot perform the contractions necessary, I beleive, to push the waste through my body. I swell with toxins. I notice it is at its worst when my toes swell from the toxins as well. I have to give up all fiber as I cannot digest it or break it down. I am forced to take laxitaves like milk of magnesia and suppository laxitives at least 2x a week or I develop horrific blockages which I fear can burst and become sepsis. A recent episode last week sent me to the ER where x-rays ordered to be sure blockage passed. It had but the inflammation, pain and gas are horrific. You cannot even touch my left side abdomin (abdomen) without pain. I am not able to eat fruit, vegetables, whole grains etc., I am losing vitamins and now adding ensure to my diet. They say the only possible thing they could do would be to find an abdominal wall specialist to try and tighten it, however I was warned that these surgeries are loaded with serious complications and tend to fail. I'm terrified I'm going to end up on a bag or something. My gastro doctor, primary, etc.,could not answer what was wrong with me...finally a plastic surgeon and my new oncologist says this is a side effect that is just beginning to show up in more and more woman. A warning to other woman, the bulge became it's largest after lifting heavy objects such as heavy grocery bags upstairs...it doesn't take much...you must NEVER lift anhything heavy again...yeah, like that's a possibilty...so, this is kind of a statement to throw out there on a serious side effect of the pedicle tram flap that certainly is being ignored in the medical community...and my question is, is there any hope? Will this neccesety of laxitives (I'm only 50) cause me to be dependent always. If the blockage does not pass can it burst and can I go sepsis? Thank you.


This discussion is related to pedicle tram flap complications.
14 Comments Post a Comment
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962875_tn?1314213636
Hi,

Sincerely sorry to hear all the difficulties you've been having!

We very frequently hear similar complaints related to the Tran Flap procedure. If you put that term in the search box for this community, you will find countless previous related threads.

We specialize in answering questions about breast cancer and breast health in this community, however, so I'd suggest you post your GI-related medical questions in one of the expert forums, such as Digestive Disorders/Gastroenterology or Cosmetic and Reconstructive Surgery.

Best wishes,
bluebutterfly
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2827584_tn?1340583296
I'm not sure about the "new procedure" in 2004. TRAM flaps have been pretty commonplace since 1980. Hernias are fairly common - especially in the few that had bilateral TRAM flaps. This was well known in 2004. In fact, many plastic surgeons at that time went ahead and performed mesh repairs of the defect in anticipation of the impending hernia. The fact that these procedures were done without entering the peritoneal cavity makes them generally straightforward for laparoscopic repair.
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Avatar_f_tn
Yes, I am incorrect in stating they were new in 2004...rather new in my area. We were warned about possibilty of hernia for the initial few months.  The new procedure sparing the abdominal rectus muscle has greatly improved and lessened side effects of this surgery. Plastic surgeon told me that they are seeing these "Bulges" (they are not hernia's, weakened abdominal/stretched wall) more and more often. The Plastic surgeon also is the one who told me that repair of the abdominal wall could be attempted with an abdominal wall surgeon, however doubted successfull outcome and warned of even worse side effects.
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Avatar_f_tn
Thanks luebutterfly, I will search!
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Avatar_f_tn
It's a little hard to describe without a photo, however you can actually see the outline of my intestines on my left side. Oncologist and Plastic surgeon informed me of the trouble with intestinal blockages. Again I reiterate, I do not have a Hernia.
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Avatar_m_tn
I also had a double tram flap done in 2004.  In 2009 I had repair of hernia and mesh from hip to hip and rib to rib b/c the lining of my stomach was so compromised and weakened. I just last weak 7/23/2012 had a small bowel obstruction surgery, and the "tacks" used to keep the mesh in place were removed as they were sharp and actually cut the surgeons glove.  I was not properly informed of all the possible complications or I would have just gotten the in plants!  This has been a living hell that never ends and I have been in pain almost every day since my original surgery!  This is barbaric and NO women should ever have it!
Debra L Peach
CT  
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Avatar_m_tn
I also had a double tram flap done in 2004.  In 2009 I had repair of hernia and mesh from hip to hip and rib to rib b/c the lining of my stomach was so compromised and weakened. I just last weak 7/23/2012 had a small bowel obstruction surgery, and the "tacks" used to keep the mesh in place were removed as they were sharp and actually cut the surgeons glove.  I was not properly informed of all the possible complications or I would have just gotten the in plants!  This has been a living hell that never ends and I have been in pain almost every day since my original surgery!  This is barbaric and NO women should ever have it!
Debra L Peach
CT  
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Avatar_m_tn
I cant tell you how glad I am to find this website and to see that I am not the only one having such a problem following tram flap reconstruction.
I had a tram flap reconstruction in 1998 after 5 previous failed attempts with implants that infected or burst.  It was a nightmare from the off, what could go wrong did go wrong. After three days the abdonimal incision broke down and started oozing and it was then noticed that the sugeon had not put in a mesh, I then got an infection in the naval and at the breast area. I spent a month in hospital and ended up with one boob 3 cups sizes smaller than the other one (the reconstruction being the smaller).  After a month or so I noticed a lump in my stomach, so after waiting 2 more months went to see the surgeon who said I had a hernia and would need a mesh inserted. When i mentioned that the reconstructed boob was much smaller he stated "well you shouldn't have expected the body of an 18 year old" I was quite taken aback and he then said "we can always reduce the good boob, unless of course you like having large breasts!"  I was quite upset by this remark, and said that I had already had it reduced when I had my first reconstruction and was not going to have it done again.  In 2000 I had the mesh inserted but again 3 months later developed a large bulge I was told the mesh had broken down and would need another one put in. This was done in 2002 and yes it again broke down and the mesh ended up rolled up round my middle. After the second op the drain was taken out too soon and I developed fluid build up and had to go back to hospital every other day for 2 weeks to have it drained off.  In the end I was so depressed I just gave up going back.  I was in such a lot of pain and discomfort I went to a pain clinic,   Well 10 years down the line and things are really no better, the bulge has got much bigger and spread over most of my tummy and at times really painful with a stinging sensation as if the whole thing is going to burst.  It has affected my bowel movements and I get the most dreadful wind, (luckily I live on my own!!).  It is the pain which is the worst but I dont seem to get anywhere with the doctors who just dont seem to understand.  I have changed surgeries in the hope that a new doctor may be more sympathetic.  I am soooo cross with myself for going through this but I just wanted to look like myself again, is that wrong?  The surgeon who did the tram flap just did not care and I wish I had never met him, he was horrible to me. I understand that this op is not done anymore and I am glad for that. I am now seeing a counsellor as all this has had quite an effect on me.
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Avatar_m_tn
I too have had a tram flap reconstruction on the right side about 10 years ago and my stomach is huge, size 16 at the waist, and size 12 everywhere else. My stomach expands 3-4 inches after I eat, I have to lay down, I cannot walk or breathe easily.  I feel like an old lady.  I cannot work, I cannot bend over, etc. I went to the best Univ. of Miami hernia surgeon and he said from the CT scan of the stomach it was a "thickening of the stomach wall" not a hernia and that if he operated and inserted mesh to push down the bulge, it would cause more pain, told me to leave it alone.  Every day I cry and am in pain and complain to every doctor I see.  No one has suggestions or can fix my problem.  I also have IBS and have had all kinds of tests, colonscopy, CT scans of my stomach, and ultrasounds and no one can find anything wrong except the bulge and the thin and thickening of the stomach wall.  The last CT scan I had with contrast was to look and see if the main blood vessel going into the stomach was constricted or blocked from the large "load of bread on the right side" hernia I have (even though the Dr. says it's not a hernia, I can see the large loaf of bread when I lay on my back and lift my head.  I am single, no man wants to date me with my large pot belly and my pants fall below my belly and I can hardly walk after I eat.  I have tried to lose some weight (I'm 168 lbs and in my 60's) but to no avail.  My grandkids make fun of my tummy and I hate it but I'm so depressed and sad, cooking is my love but most of the food I cannot eat.  I have just started on a low-fodmap diet and am trying to do this but there is so much I cannot eat.  Can anyone help me????
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Avatar_m_tn
I had breast reconstruction in 2003, I've not been the same since, can not carry anything , can not walk my 10km that I use to, now I have Rectom prolapse and bladder buldge,and need surgery,I'm afraid i might get worse ,my plastic surgeon never warned me of any complication in the future ,and Iworn all woman not to get the flap reconstruction done, what should I do..
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Avatar_n_tn
Hi my name is Ellen, live in Perth west Australia. Had my double mastectomy in August 2012. It is now January 2014 and I too have had terrible bouts of constipation ever since the surgery. These bouts at first were spread by weeks .. Now it is every week.  The bulge is huge on the right side as that is where the donor  ab muscle was harvested. My left breast was compromised as I had breast cancer in 2007 and had radiotherapy. Then in May 2012 after many biopsies found the cancer had returned to the same breast .. So obviously to me, I chose a bilateral mastectomy  using the TRAM and DIEP methods.  The right breast is smaller as it already was compromised by radiotherapy so had tissue necrosis.  The left side is significantly larger. But I am alive.  It's the bulge and the constant constipation that are annoying.  I will see my GP tomorrow as my ultrasound showed no obvious hernia.  Has anyone had or tried colonic irrigation?
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Avatar_n_tn
Hi my name is Ellen, live in Perth west Australia. Had my double mastectomy in August 2012. It is now January 2014 and I too have had terrible bouts of constipation ever since the surgery. These bouts at first were spread by weeks .. Now it is every week.  The bulge is huge on the right side as that is where the donor  ab muscle was harvested. My left breast was compromised as I had breast cancer in 2007 and had radiotherapy. Then in May 2012 after many biopsies found the cancer had returned to the same breast .. So obviously to me, I chose a bilateral mastectomy  using the TRAM and DIEP methods.  The right breast is smaller as it already was compromised by radiotherapy so had tissue necrosis.  The left side is significantly larger. But I am alive.  It's the bulge and the constant constipation that are annoying.  I will see my GP tomorrow as my ultrasound showed no obvious hernia.  Has anyone had or tried colonic irrigation?
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Avatar_f_tn
I had a bilateral mastectomy in 1999 with pedicled TRAM flap. Here I am 13-14 years later and am experiencing the same things you describe. I experience bulging, bloating, increased gas, indigestion, pain. The pain worsens when I lift things such as groceries. Last spring I ended up in the ER with severe pain. It was determined that fluid was collecting on top of the mesh that was inserted to support the abdominal wall in 1999. Some docs have said there is no way this can be related to surgery in 1999. A plastics doc referred me to a general surgeon who said that the risks of opening the abdomen outweigh any benefits that might be gained due to the possibility of infection. A plastics doc that specialized in breasts made me feel crazy bc the pedicled TRAM isn't performed anymore. I look like I am 3 or 4 months pregnant. I have to wear pants below the bulge bc any pressure on the abdomen is uncomfortable. I wear maternity tops because they hide my bulge.  Have any of you found any relief or answers? Obviously we are not crazy and this is very real.  Any comments or suggestions are welcome!
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Avatar_f_tn
good afternoon I ahd the tramp flap procedure in 2001 in the UK, I do have a right sided bulge which is very unsightly. But what i ahve experienced is unexplained episodes of stomach pains cramps and unexplained episodes of diahorrea and vommiting, which comes on suddenley and unexplained.
Not food related, but takes about a week to subside.

Can this be along term effect of tram flap procedures, I dno nto know what type of mesh was used in my operation.
many thanks
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